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Quietly Pressing: The Racial and Gender Politics of Asian Massage Work
No full text“Quietly Pressing” explores the class, gender, racial, and labor politics in the U.S. massage work industry by focusing on the work and lived experiences of Chinese and Chinese American women massage workers (hereinafter “Chinese massage workers”). Grounded in ethnography and in-depth interviews with Chinese massage workers in the Los Angeles metropolitan area, my research brings workers’ stories to explore how they experience, wrestle with, and do massage work in the context of racialized, sexualized Asian massage work. I argue that Chinese massage workers’ stories and strategies reveal the deep hierarchies of labor used to justify the ongoing devaluation of women of color’s labor, particularly migrant women. Nevertheless, Chinese massage workers learned to push back and create better conditions for their work and life. This dissertation investigates the range of creative strategies Chinese women develop, from highlighting genuine care to displaying health knowledge to remaining quiet, as they navigate their lives as Chinese massage workers. Chinese women’s stories teach us about the demands of care, the blurred boundaries between health and sex, and how we can minimize, refuse, and even resist work in the meantime. By minimizing emotional labor exerted at work through quiet tactics of withholding, these women are preserving the bandwidth for engaging in emotional labor with the care recipient they select. In other words, by withholding care from the client, the intended care recipient, Chinese massage workers are pilfering their care, which is expected by management to be exerted at work, to preserve their energy to redistribute it to their chosen care recipient such as their friends and children. This preservation and redistribution of care is resisting the working conditions of socially necessary care and refusing the capitalist logic of care that hierarchize deserving care receiving and giving subjects. My work frames Chinese workers as knowledge producers, recognizing and examining the various working conditions they navigate and struggle against, often with grace and sometimes quietly. Centering Chinese workers’ negotiations of massage work, my research takes seriously the racialized and sexualized history of Asian women’s care labor to highlight how workers push back against narratives that oversexualize their work and seek to redefine the value of their labor. Drawing from feminist theories of work, I examine both Chinese massage workers’ disavowal of sex work and parallel insistence on the significance of intimate care work, highlighting how they engage subversive tactics to redefine hard work. I use a multisensorial ethnographic method to highlight how Chinese massage workers’ stories expose the problem with racializing and sexualizing massage work, the problem is with work at large, and how we might imagine and study new strategies of wrestling with and maybe even resisting work. Altogether, the story I tell unfurls some of the brilliant strategies these Chinese women massage workers use to fight against this complex nexus of power relations that misunderstands, diminishes, and criminalizes their labor
A Woman with Abdominal Pain
Get PDFCase Presentation: A 28-year-old woman with a history of cocaine and opioid use disorder presented to the emergency department with abdominal pain, nausea, and vomiting for two days. She’d had irregular bowel movements with constipation for quite some time. Physical exam was notable for diffuse peritonitis and melena on digital rectal exam. Patient had a witnessed episode of hematochezia. Computed tomography of the abdomen and pelvis with intravenous contrast demonstrated sigmoid colon intussusception, and the patient underwent emergent surgery for definitive treatment. Specimen was sent to surgical pathology and revealed no lead point.
Discussion: While sigmoid intussusception is not a rare finding, it is exceedingly rare in young adult patients who do not have a pathologic lead point. Lead points are areas of inflammation, lesions, or masses that snag the bowel and initiate the process of telescoping that ultimately results in an intussusception. This patient was not found to have such a lead point on gross examination during surgery or on extensive specimen examination in the pathology lab. Instead, her sigmoid intussusception is hypothesized to be secondary to decreased gut motility in the setting of chronic opioid use disorder
Abortion, Anemia, and an Account of Idiopathic Intracranial Hypertension: A Case Report
Get PDFIntroduction: Idiopathic intracranial hypertension is a rare but serious cause of headache. Prompt diagnosis and treatment is needed to prevent permanent neurologic sequelae.
Case Report: We present a case of a 32-year-old female with multiple emergency department visits for a headache after having a medical termination of pregnancy. She was found to have severe anemia, retained products of conception, and radiographic findings suggestive of idiopathic intracranial hypertension, which was confirmed by an elevated opening pressure on lumbar puncture. Her symptoms improved after transfusion of packed red blood cells, initiation of acetazolamide and corticosteroids, and manual uterine evacuation. She was ultimately discharged without any neurologic deficits.
Conclusion: Idiopathic intracranial hypertension is a rare but serious cause of headache, and anemia is an underappreciated precipitating factor. The hormonal changes associated withpregnancy may further predispose patients to this rare medical condition, especially in the setting of vaginal bleeding
Improving adherence to endocrine long-term follow-up guidelines in Hematopoietic stem cell transplantation survivors: A Quality Improvement project at Rady Children’s Hospital
No full textBackground: Hematopoietic stem cell transplantation (HSCT) survivors are at risk for developing late complications secondary to peri-transplantation exposures. National guidelines recommend screening for late effects of HSCT, including endocrine disorders. At our institution, we observed that adherence to guidelines was suboptimal. Among pediatric allogeneic HSCT recipients with hematologic malignancy or severe aplastic anemia (SAA) diagnosis, only 1/16 patients (6%) received all the recommended screening evaluations/tests at 12 and 24 month follow-up visits between January and September, 2023.Methods: Global Aim: Improve long-term endocrine health in HSCT survivors.SMART Aim: From July 1, 2024 to May 31, 2025, the percentage of allogeneic HSCT recipients with hematologic malignancy or SAA diagnosis at Rady Children’s Hospital-San Diego, who receive all the recommended endocrine screening evaluations/tests at 12 and 24 months after transplant, will increase from 6% to 60%. Our interprofessional team (oncology, nursing, IT) used Quality Improvement (QI) tools (process mapping, fishbone and key-driver diagrams) to inform interventions: Provider education sessions, tip sheets, Epic order panel, and Epic smart-phrase with list of test results to be included in clinic notes.Process measures include: Percent of clinic visit notes at 12 and 24 months post- HSCT for hematologic malignancy or SAA in which new Epic smart phrase was utilized. Percent of clinic visits at 12 and 24 months post- HSCT for hematologic malignancy or SAA in which new Epic order panel was utilized.Balancing measures include: Provider satisfaction with new process, measured via survey.Results: Within the first 3 months from project roll out (PDSA1) the percentage of HSCT recipients who received all the recommended endocrine screening evaluations/tests at 12 and 24 months post-HSCT increased to 33%. Only 3/9 evaluated patients had Tanner stage documented. Adherence to all other screening tests was 100% (increased from 25% at baseline). The Epic smart-phrase was utilized in 9/9 (100%) of clinic notes. The Epic order panel was utilized in 5/9 (56%) of evaluated clinic encounters. The PDSA2 is currently ongoing with 3 patients evaluated so far. All had 100% of screening evaluations/tests, including Tanner stage, performed.Conclusions: After PDSA1, we increased adherence to endocrine screening evaluations/tests for HSCT survivors. Interprofessional collaboration, provider engagement and use of newly developed Epic tools facilitated improvement. However, we have not yet reached our goal. During PDSA2 we are focusing our strategy on improving adherence to Tanner stage documentation, identified as the main contributor to not achieving our SMART Aim. Additional interventions for PDSA2 included additional provider education sessions and updated tip sheets to emphasize inclusion of tanner staging
Unlocking ecological insights from sub‐seasonal visible‐to‐shortwave infrared imaging spectroscopy: The SHIFT campaign
Get PDFWe stand at the threshold of a transformative era in Earth observation, marked by space-borne visible-to-shortwave infrared (VSWIR) imaging spectrometers that promise consistent global observations of ecosystem function, phenology, and inter- and intra-annual change. However, the full value of repeat spectroscopy, the information embedded within different temporal scales, and the reliability of existing algorithms across diverse ecosystem types and vegetation phenophases have remained elusive due to the absence of suitable sub-seasonal spectroscopy data. In response, the Surface Biology and Geology (SBG) High-Frequency Time Series (SHIFT) campaign was initiated during late February 2022 in Santa Barbara County, California. SHIFT, designed to support NASA's SBG mission, addressed mission scoping, scientific advancement, applications development, and community building. This ambitious endeavor included weekly Airborne Visible InfraRed Imaging Spectrometer-Next Generation (AVIRIS-NG) imagery acquisitions for 13 weeks (spanning February 24 to May 29, 2022), accompanied by coordinated terrestrial vegetation and coastal aquatic data collection. We describe the rich datasets collected and illustrate how the complex sub-seasonal patterns of change can be linked to biological science and applications, surpassing insights from multispectral observations. Leveraging open-source processing methods and cloud-based analysis tools, the SHIFT campaign showcases the readiness of the scientific community to harness ecological insights from remotely sensed hyperspectral time series. We provide an overview of SHIFT's goals, data collections, preliminary results, and the collaborative efforts of early career scientists committed to unlocking the transformative potential of high-frequency time series data from space-borne VSWIR imaging spectrometers
Federalism & Native Hawaiian Claims: Toward an Equitable and Just Solution
Get PDFThis article discusses a hypothetical case: on behalf of the Native Hawaiian People as a whole, a group of Native Hawaiians has petitioned a Hawai’i State court seeking two declaratory rulings. First, a declaration that Native Hawaiians have not lost their inherent sovereignty as an indigenous people. Second, a declaration that Native Hawaiians collectively retain a beneficial interest in the former Crown Lands of Hawai’i. The article responds affirmatively to those requests, in the form of a draft opinion by a fictional Justice of the Hawai’i Supreme Court. Citing long settled U.S. federalism doctrine, the text explains that the State of Hawai’i possesses concurrent power with the United States to recognize the inherent sovereignty of Native Hawaiians, and to define the legal scope of that sovereignty as a matter of Hawai’i law. Relying upon exisiting Hawai’i legislation, exisiting Hawai’i Supreme Court precedent, and a similar doctrine developed by the Supreme Court of Canada, the text concludes that Native Hawaiians collectively retain a usufructary right in the remaining publicly-owned Crown Lands. Finally, this article envisions only incremental steps. It is intended and respectfully submitted without prejudice of any kind, conceptual or otherwise, to other, further theories of Native Hawaiian sovereignty and restorative justice
Predictors of Donor‐Site Wound Complications Following Fibula Free Flap Reconstruction
Get PDFObjectiveThe fibula free flap (FFF) remains the workhorse flap for head and neck defects necessitating osteocutaneous reconstruction. Although lower extremity angiography, ultrasound (US), and other vascular studies are routinely used for fibula assessment and patient selection, predictors of donor-site morbidity following harvest remain poorly understood. We sought to investigate the factors associated with FFF donor-site complications.Study designRetrospective analysis of patients at a tertiary care center.SettingTertiary care center.MethodsIn total, 119 patients undergoing FFF reconstruction during the years 2012 to 2022 were included. Multivariable logistic regression was used to identify independent predictors of soft-tissue donor-site wound complications.ResultsA total of 48 (40.3%) patients developed a donor-site wound complication with an average time to diagnosis of 24 days (±16) following surgery. In multivariable regression, history of alcohol use disorder (P = .0083) and method of donor-site closure (P = .0368) were independent predictors of donor-site wound complications. Split-thickness skin graft closure was associated with a 146% increased odds of wound complications (odds ratio [OR] = 2.46, 1.11-5.43, 95% confidence interval). Patient age, body mass index, Charlson comorbidity index, skin paddle size, and Doppler US characteristics were not predictive of postoperative donor-site morbidity.ConclusionPredictors of FFF donor-site wound complications included history of alcohol abuse and method of donor-site closure. This study highlights unique lower extremity Doppler US findings in patients undergoing FFF reconstruction in addition to modifiable risk factors associated with fibula donor-site morbidity and soft-tissue complications. Our findings underscore the need to critically evaluate wound closure techniques in this population
Cortisol and Catecholamine Concentrations Are Affected by Repeated Relocations of Adult Female Rhesus Monkeys (Macaca mulatta).
Get PDFIn captive primate facilities, relocations-moves, within the facility, from one cage to another-can be common events. On the one hand, relocations are generally regarded as relatively benign events, as past studies have generally shown only transient elevations in cortisol concentrations following relocation. On the other hand, the frequency of relocations has been associated with adverse health and behavioral outcomes. As part of a larger project examining the effects of stress on follicular development, we relocated adult female rhesus monkeys on a weekly basis for several months in each of 3 years, and measured concentrations of urinary cortisol, epinephrine, and norepinephrine, as well as hair cortisol. Results for urinary cortisol and epinephrine were similar: significant elevations immediately following initiation of relocations during Years 1 and 3, and reductions in concentrations by the end of the relocation sequences in Year 1. No changes were seen for these two measures in Year 2. In contrast, elevated norepinephrine concentrations were found for all 3 years. Significant elevations in hair cortisol concentrations were found for Years 2 and 3, and suggested persisting and cumulative effects of relocations on the hypothalamic-pituitary-adrenal axis. Together, these results suggest that relocations may not be the benign events suggested by earlier studies. Given that all organs of the body are innervated by the sympathetic nervous system (the principal source of norepinephrine in blood and urine) and that cells of the body have glucocorticoid and catecholamine receptors, our results suggest possible mechanisms by which repeated relocations may result in adverse health outcomes. Repeated relocations may be a valuable model for experimentally generating moderate stress; however, we encourage colony managers and scientists to minimize such events to enhance the welfare of the animals
Directed evolution of aminoacyl-tRNA synthetases through in vivo hypermutation.
Get PDFGenetic code expansion (GCE) is a critical approach to the site-specific incorporation of non-canonical amino acids (ncAAs) into proteins. Central to GCE is the development of orthogonal aminoacyl-tRNA synthetase (aaRS)/tRNA pairs wherein engineered aaRSs recognize chosen ncAAs and charge them onto tRNAs that decode blank codons (e.g., the amber stop codon). However, evolving new aaRS/tRNA pairs traditionally relies on a labor-intensive process that often yields aaRSs with suboptimal ncAA incorporation efficiencies. Here, we present an OrthoRep-mediated strategy for aaRS evolution, which we demonstrate in 8 independent aaRS evolution campaigns, yielding multiple aaRSs that incorporate an overall range of 13 ncAAs tested. Some evolved systems enable ncAA-dependent translation at single amber codons with similar efficiency as natural translation at sense codons. Additionally, we discover an aaRS that regulated its own expression to enhance ncAA dependency. These findings demonstrate the potential of OrthoRep-driven aaRS evolution platforms to advance the field of GCE
Bolstering spatial learning in the primary classroom: identifying the factors underlying primary teachers’ spatial pedagogical practices
No full textTeachers’ cognition and affect can influence their pedagogical choices, which in turn can shape the development of their students’ spatial skills. Here we examined the relations between primary teachers’ spatial cognition, affect, and their inclination for choosing teaching practices, such as models and diagrams, that engage and facilitate spatial learning. Seventy-seven K-6 teachers completed measures of spatial skills, spatial anxiety, spatial habits of mind, and a measure of preferences for spatial pedagogy. Additionally, we assessed and controlled for their general reasoning and general anxiety. Results revealed primary teachers’ spatial skills were positively associated with their spatial habits of mind and their preference for using spatial strategies for teaching science content. Yet, their pedagogical preferences for teaching math content varied with their teaching experience. Teachers’ spatial skills and spatial anxiety were not related. These findings have implications for how to leverage teacher education programs to bolster primary STEM learning and outcomes